Got cold medicine?

Reading labels might clarify the best remedy for symptoms

Reading labels might clarify the best remedy for symptoms

November 07, 2005|by JULIE E. GREENE

So you've got a cold and you're shopping for medicine to relieve your symptoms.

These days it's a little easier, thanks to U.S. Food and Drug Administration-required label changes in the late 1990s. The FDA required that over-the-counter medications, such as cold medications, list the active ingredients and specify what each is supposed to do.

But some cold medications might still be a bit confusing or perplexing, like Robitussin Cough that contains both a cough suppressant and an expectorant. One helps suppress cough while the other pretty much does the opposite, trying to help the body evict mucus.

An expectorant, which is usually guaifenesin, is supposed to thin mucus, whether it's in the lungs or nose, says Dr. John Reed, an internist and pediatrician with Smithsburg Family Medical Center.


"The idea is it's supposed to help you mobilize your secretions a bit and help you cough things up," Reed says.

Sometimes coughing doesn't mobilize stubborn mucus so the expectorant thins it out to help coughing get rid of it, he says.

However, a cough suppressant blocks the cough reflex, he says.

The combination of a cough suppressant and an expectorant tries to make the cough less of an issue so people can sleep, he says.

Some Robitussin formulas contain a cough suppressant and expectorant, however the cough suppressant, dextromethorphan, doesn't entirely suppress the cough, says Fran Sullivan, spokesman for Madison, N.J.-based Wyeth Consumer Healthcare, which produces Robitussin.

So people still are going to cough and the expectorant, guaifenesin, makes the coughs more productive, Sullivan says.

Bobbi Hilker, pharmacist with Home Care Pharmacy, suggests people take a medication with an expectorant during the day and take one that also contains a cough suppressant at night to help loosen mucus in the chest and get rid of that uncomfortable feeling, and to help sleep.

"It's really hard, when you look at a drug, to get it to do exactly what you want it to do," Hilker says. Over-the-counter medications allow people to seek relief without seeing a doctor, but it's still important to talk to a doctor or pharmacist when choosing a medicine, she says, because it can be confusing.

Acetaminophen, which is a generic for Tylenol, is taken for pain relief and to reduce fever, Reed says. Raising body temperature makes it harder for viruses and bacteria to do what they do.

Antihistamine is really not important for most colds or infection-type problems, Reed says.

When the body senses a foreign body such as dust mites, ragweed or pollen, it sends in the body's histamines, Hilker says. Histamines are part of a body's natural defenses. They make the nose runny, to try to get the pollen or virus out, and cause itchy eyes.

Reed says histamines are more important in an immune system's response to allergies such as pollen, than to viral infections.

Reed says antihistamines, which block histamines, are probably included in cold medications more for their side effects. The side effects include some drying of secretions - drying up a runny nose - and drowsiness. For people with a cold who are having trouble sleeping, the antihistamine often will cause sleepiness and help them rest better.

Also, many cold medications contain pseudoephedrine, which is a stimulant, Reed says. Taking a medication with pseudoephedrine too close to bedtime can interfere with sleep, so the antihistamine might counteract that effect.

Some cold medications state they are pseudoephedrine free.

Pseudoephedrine and phenylephrine are nasal decongestants.

So is phenylpropanolamine. However, the FDA issued a public health advisory regarding phenylpropanolamine in November 2000. A study reported that taking the nasal decongestant increases risk of hemorrhagic stroke in women and that men could be at risk too, according to the advisory posted online at

The FDA recommends people not use products containing phenylpropanolamine and requested companies stop marketing products containing it, according to the phenylpropanolamine information page at

Nasal decongestants shrink or tighten blood vessels and might raise blood pressure, so products containing nasal decongestants might have warnings for people with high blood pressure, Reed says.

ose, it attacks the lining of the nose, destroying or injuring cells, which triggers inflammation, Reed says. As blood vessels dilate or enlarge to get white blood cells to the area to fight infection, fluid leaks out of the blood.

This causes mucus to come out of the cells and decreases the space in the nasal passages through which air can travel, hence the runny and stuffy nose, Reed says.

Remember, there is no cure for the cold - other than time, Reed says.

Cold medications contain ingredients to address the symptoms - stuffy and runny nose, fever and coughing - the very things the body is doing to fight the virus, Reed says.

Hilker says the body is doing other things to battle the virus, more than the runny nose and congestion, so just look for medicine that addresses your specific symptoms.

The bottom line is cold medications are trying to help relieve the discomfort of a symptom or symptoms that are annoying or disrupting a good night's rest, Reed says.

Over-the-counter cold medications are not significantly interfering with the body's ability to get rid of an infection, he adds.

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